[Complications of the surgery in the reassignment of sex].
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Adult↗
Biomedical subjects
J M Cuesta Presedo
Publications and source records attributed to J M Cuesta Presedo.
[Intravesical foreign body].
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Foreign Bodies↗
[Unusual association of transitional cell carcinoma in the upper urinary tract, with contralateral renal metastasis and renal lithiasis of long clinical course].
Presentation of a case reporting an infrequent association of transitional cell carcinoma of the upper urinary tract (UUT) with a long-standing renal polylithiasis and multifocal metastasis in contralateral kidney. A description is made of the incidence, etiology, prognostic factors as well as diagnosis and therapeutical approach.
Carcinoma, Transitional Cell↗
[Primary retroperitoneal hydatidosis].
Genitourinary involvement by the Echinococcus granulosus larvae (urinary hydatidosis) ranks third in order of frequency after liver and lung involvement. The finding of a primary hydatidic cyst with retroperitoneal location is an uncommon fact. This paper presents once case of this infrequent disease. A revision of the different etiopathogenic mechanisms, as well as diagnostic and therapeutic approaches is made.
Aged↗
[Retroperitoneal cystic mass. Giant exophytic gastric leiomyosarcoma].
Presentation of an unusual case of pre-operatively non-striated retroperitoneal cystic mass confirmed to be a gastric leiomyosarcoma after pathoanatomical study. Considering the rarity of the case, we reviewed the literature as well as the epidemiological, clinical, pathoanatomical and surgical characteristics of gastric leiomyosarcomas which, as in the present case, can appear as retroperitoneal mass.
Diagnosis, Differential↗
[Early diagnosis of cancer of the prostate. 5-year analysis].
The authors present the results obtained using a program for early diagnosis in symptomatic patients, within a specific population area. The effectiveness of this diagnosis program for prostate cancer, which is expected to be used also for diagnosis of less advanced stages, is established with the analysis of results obtained in 1000 patients: 42.5% positive biopsies. Biopsy indication in case of suspicious rectal examination and/or PSA over 10 ng/ml is considered useful. There are more reservations towards this indication with PSA values between 4 and 10 ng/ml, where evaluation of other complementary options is considered necessary.
Adult↗
[Erectile dysfunction after radical prostatectomy. Etiopathology and treatment].
Erectile dysfunction is one of the most common sequela from radical prostatectomy. The authors evaluate the incidence of erectile dysfunction after radical prostatectomy, study the likely causative vascular mechanisms and assess the efficacy of the treatments employed. Two hundred and four (204) radical prostatectomies were analyzed. 163 (80%) patients referred adequate erections prior to surgery. In 82 cases, surgery was performed with the intention of preserving one or both bands. For the remaining cases, radical surgery with exeresis of both bands was performed. Due to secondary erectile dysfunction, 75 patients were studied by preparing: clinical history, laboratory tests, penile neurophysiological studies and intracavernous prostaglandin E1 injection test. Dynamic drug-cavernosmetry was performed in 36 patients. After radical prostatectomy, only 9.2% previously potent patients retained adequate erections. Of the 82 cases where preservation of one or both bands was attempted, 9 (11%) patients retained their erections. Changes in neurophysiological parameters were found in 69.2% cases and general vascular injury detected in 23 (63.8%) patients by drug-cavernosmetry, the main injuries being cavernous arteries insufficiency in 58.3% and veno-occlusive failure in 33.3%. Of the 75 patients studied, 48 accepted the treatment: 40 (81.6%) used intracavernous auto-injection, 8 had penile prosthesis inserted, and one patient uses a vacuum device. Intracavernous Pg E1 auto-injection has provided adequate stiffness in 95% patients and, at 6 months from onset of treatment, a decrease of the minimal effective dose has been seen which is more noticeable in men under 60 and patients who start treatment within 6 months.
Aged↗
[Long-term results of the treatment with intracavernous injection of vasoactive drugs].
OBJECTIVES: To evaluate the long-term results of treatment of erectile dysfunction with intracavernous self-injection of vasoactive drugs. METHODS: The study comprised 144 patients treated with intracavernous self-injection. The most common etiologies were arterial (27%), corporal-veno-occlusive (22.2%) and diabetic (17.5%). The mean follow up was 15.6 months (range 12-44) and the total number of injections was 7,190. PGE1 was utilized in 135 patients and papaverine + PGE1 in 9 patients. RESULTS: Patients with psychogenic or neurogenic impotence responded to low doses of PGE1 (9.6 microgram and 8.4 microgram, respectively). Adequate rigidity was achieved in 96% for over 30 min in 90%, and coitus was satisfactory in 92%. There were 20 (13.9%) dropouts and 5 (3.5%) recovered erection. The most important local complications were intense pain (4 pts, 0.05%), prolonged erection (3 pts, 0.04%) and secondary fibrosis without penile curvature (3 pts, 2.1%). Systemic complications were observed in only 4 cases: palpitation (1 pt), headache (1 pt) and dizziness (2 pts). CONCLUSIONS: Patients with psychogenic and neurogenic impotence responded to low dose therapy, whereas those with veno-occlusive impotence required the highest doses of PGE1 or papaverine + PGE1. This pharmacological erection program achieved adequate rigidity in 96% and satisfactory coitus in 92%. There were minimal complications: prolonged erection (0.04%), intense pain (0.05%) and fibrosis (2.1%).
Alprostadil↗